射频消融联合重组人血管内皮抑素治疗非小细胞肺癌近期疗效的非随机对照试验

Short-term outcome of radiofrequency ablation combined with endostar in the treatment of non-small cell lung cancer:A non-randomized controlled trial

目的探讨射频消融联合重组人血管内皮抑素治疗非小细胞肺癌的效果。方法将2013年12月至2014年12月首都医科大学宣武医院胸外科连续80例非小细胞肺癌患者(男50例,女30例)分为重组人血管内皮抑素联合射频消融联合治疗组[60例,男38例、女22例,平均年龄(67.77±10.43)岁]和单独射频消融组[20例,男12例、女8例,平均年龄(67.35±9.82)岁],联合治疗组再根据重组人血管内皮抑素的肿瘤血管"正常化"时间窗为1～3 d,分为重组人血管内皮抑素治疗前射频消融组(20例)、重组人血管内皮抑素治疗1～3 d射频消融组(20例)、重组人血管内皮抑素治疗4～7 d射频消融组(20例)。胸部CT动态随访患者局部复发时间,评价近期疗效及安全性。结果各组间局部复发时间差异有统计学意义(χ~2=11.05,P=0.011),联合治疗组优于射频消融单独治疗组,并且在重组人血管内皮抑素的肿瘤血管"正常化"时间窗内联合治疗近期效果最好。与单独射频消融治疗相比,本研究常见并发症均与射频消融有关。无重组人血管内皮抑素相关并发症发生,联合治疗组不存在安全性问题,组间差异无统计学意义(χ~2=0.889,P>0.05)。结论射频消融联合重组人血管内皮抑素治疗非小细胞肺癌有安全有效。

Objective To study the short-term outcome and safety ofradiofrequency ablation （RFA） combined with recombinant human endostatin （endostar） for non-small cell lung cancer （NSCLC） patients. Methods Between December 2013 and December 2014, 80 consecutive patients （50 males, 30 females） with biopsy-proved NSCLC were divided into two groups： a RFA combined treatment group （RFA combined with endostar, 60 patients, 38 males, 22 females, mean age at 67.77±10.43 years） and a RFA alone group （20 patients, 12 males, 8 females, mean age at 67.35±9.82 years）. The RFA combined treatment group was divided into three groups according to vascular normalization window of endostar and 20 patients in each group： a combined treatment group 1 （transfusion of endostar after RFA）, a combined treatment group 2 （transfusion of endostar for 1 to 3 d before RFA） and a combined treatment group 3 （transfusion of endostar for 4 to 7 d before RFA）. The CT scan of the chest was followed up after the treatment, local recurrence and safety was observed. Results There was a statistical difference in local recurrence time among groups （χ2 = 11.05, P = 0.011）. The effect of the combined treatment group is better than that of the radiofrequency ablation therapy alone group. And in the recombinant human endostatin of tumor vascular normalization time best combination therapy was observed in the near future effect compared with the radiofrequency ablation therapy alone. In this study common complications were associated with radiofrequency ablation. No recombinant human endostatin related complication was found. There was no satistical difference in safety between the combined treatment group and the radiofrequency ablation therapy group （χ2= 0.889, P 〉 0.05）. Conclusion RFA combined with endostar is safe and effective for non-small cell lung cancer.